Nogová L et al. (2008) Lymphocyte-predominant and classical Hodgkin's lymphoma: a comprehensive analysis from the German Hodgkin Study Group. J Clin Oncol 26: 434–439

Lymphocyte-predominant Hodgkin's lymphoma (LPHL) is a rare disease, which differs substantially from classical Hodgkin's lymphoma (cHL) with regard to histopathology and clinical course. Patients with LPHL are usually treated with the protocols used for cHL; however, the treatment of early-stage LPHL and pediatric LPHL patients is less defined. A study by Nogová et al. has compared prognosis, disease characteristics and outcomes between patients with LPHL and those with cHL.

This retrospective study included 8,298 patients previously treated within the German Hodgkin Study Group trials HD4 to HD12. Of these patients, 7,904 were diagnosed with cHL and 394 with LPHL. The rates of complete and unconfirmed complete remission in patients with early favorable, early unfavorable and advanced LPHL were 91.6%, 85.7% and 76.8%, respectively. The corresponding remission rates in patients with cHL were 85.9%, 83.3% and 77.8%. The overall survival rates for LPHL and cHL patients were 96% and 92%, respectively (P = 0.0166), while the overall rates of freedom from treatment failure at a median observation time of 50 months were 88% and 82% (P = 0.0093). For patients with LPHL, risk factor analysis identified advanced-stage disease (P = 0.0092), hemoglobin level less than 10.5 g/dl (155 g/l; P = 0.0171), and lymphopenia (P = 0.010) as negative prognostic factors for freedom from treatment failure. Negative prognostic factors for overall survival included hemoglobin level less than 10.5 g/dl (P = 0.0014), age of at least 45 years (P = 0.0125), and advanced-stage disease (P = 0.0153).

These results show that LPHL and cHL differ in prognosis, disease characteristics and treatment outcomes, suggesting that different treatment strategies could be used for patients with early-stage LPHL.